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The deadly 'D': Psychiatrists, experts help decode depression

Oscar-winning actor Robin Williams’ untimely death two weeks ago was an alarm call for those who till now never paid heed to the complexity of depression. A woman who battles depression shares her story with Nikshubha Garg, who also speaks to psychiatrists and experts to find out how family and friends can help the patient

A couple of years ago, Jyoti Basu (name changed), lost a very close friend. Since then, life has not been the same for her. She lost appetite and came down to 35 kg. She started sleeping at odd hours and would burst into tears for no apparent reason. She started to hate herself, suffered from blackouts, lashed out at people and had a tough time dealing with life in general. Falling ill had become a part and parcel of her life and at one time, she was even hospitalised. One of the doctors, concerned about her health, spoke to her mother and informed her that this was more than just a physical ailment and that she should take her to a psychiatrist. Shortly thereafter, Basu was diagnosed with clinical depression. She tells her story:

Depression

The diary of a woman battling depression

Reactions matter
People often confuse a phase of sadness with depression but for people who have suffered it, it’s impossible to confuse the two. I didn’t think I was sad. To me, my life wasn’t worth living. My family and a few friends played a very important role during this period. My mother and sister were supportive from the beginning but my father took time to come to terms with it. He would often say, ‘Why would someone need pills to behave normally?’ or ‘Why can’t you just snap out of it?’ He took some time but later, understood my situation.

As for friends, the phase made me realise who my true friends really were. A lot of them chose not to be involved and I respect their decision but those who chose to stay are like family now. Though your family always stands by you, sometimes it’s the people around you who make your situation worse. Once you are diagnosed with clinical depression, you are seen as a ‘faulty piece’. Their first instinct is to ask you to get over it or behave yourself. Those suffering from depression are often seen as badly behaved, moody and selfish. In India, you never go to a shrink unless you are crazy.

Small steps
Nonetheless, I consulted both a psychologist and a psychiatrist and was put on anti-depressants. People say that staying positive helps during depression but if only it was that easy. You can’t even think properly, forget being positive. Physical activity like taking a walk helped a lot. Surrounding yourself with your loved ones helps as well but only to a certain extent as you see how miserable they are because of you, and you tend to go back into your shell.
You know what helps? Small achievable tasks. When you are battling depression, everything seems impossible. Day-to-day activities such as getting up from bed, brushing your teeth, getting ready, going to work — everything is an unreachable goal. But those small achievable tasks can make a lot of difference to your mental state as you begin feeling worthwhile. Till date, I paint my nails once a week. It is my reset task. It’s small and means nothing to the rest of the world. But it’s one small but crucial step that helped.

Dealing with depression
Everyday tasks, like watering plants, can make a difference 

On the road to recovery, you feel numbed by the medicines you pop. Numb, according to science, is better than unhappy. Initially, I had no faith in medicines. As a result, I would skip them, consume alcohol or cut myself to avoid feeling anything but numb. But slowly, the drugs began to help. I began to eat, step outdoors and face life. Recovering for me meant moving my focus from inside my head to outside. There’s no cure though, just treatment. I’ve had to go back to my medication every now and then. It’s a constant battle.

Depression is like an illness waiting to be treated by a doctor. It’s not ‘cool’ and makes you loathe yourself. We tend to swim in our sadness and it’s tough to get out of it because we’re not really sure whether we can breathe the air outside. So force yourself to take in some fresh air every day. A few minutes of forcing yourself to smile or perhaps half an hour of indulging in your favourite things — that helps.

People will leave you. Be glad. You have no idea how better off you are going to be without them. It’s not always going to be like this, I promise.

Depression and its symptoms
If an individual exhibits symptoms of demotivation, lack of concentration and appetite, diminished pleasure, a feeling of being worthless, suicidal ideation and broken sleep for over two weeks, he/she may be suffering from clinical depression. Various stress factors such as relationships, career, parental and peer pressure can contribute to depression.

Role of family and friends
Family and friends play an important role in identifying the symptoms of depression and helping the patient recover. In India, we have a tendency to ignore behavioural changes. We think that the person is just being moody or unruly. This is where we go wrong. Depression begins with small changes in one's personality. Family and friends need to understand that the person isn't doing anything on purpose, so the possibility of ‘snapping’ out of it doesn’t exist. Also, while battling depression, everyday activities become a huge task. “Those close to the person need to appreciate the small steps they take,” says Dr Smitha Vatvani, MD, Psychiatry. Most importantly, family and friends need to realise that depression is not a disease. Sidelining someone you love could prove to be fatal for the affected person.

Critical small tasks
Psychiatry deals with medication, whereas counselling centres use various techniques to help a person battle depression. Clinical psychologist Neha Patel, who runs a healing centre called Sharnam in Juhu, says that counselling for depression happens over three levels. The first level focuses on behavioural change where they try to bring in a change in the person’s day-to-day activities. “We ask our clients to make a list of things they love doing and things they are capable of doing. We, then, incorporate these tasks in their day-to-day lives. Achieving them gives them the feeling of being worthwhile,” says Patel. “For instance, simple tasks like watering the plants, depositing money in the bank, clearing a shelf of their cupboard might seem no-brainers to us, but for them, it truly is a task accomplished,” she adds. Second, they ask the patient to speak to somebody in the family and the third is a therapy called mindfulness— a concept that teaches the affected person to live in the present, without worrying about the past or future. Patel also stresses on patients penning down four pages in a day, to help them vent their feelings. This, according to her, works wonders in helping them appreciate the good things in life.

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